Evaluation of physical examination skills. Reliability of faculty observers and patient instructors
D. L. Elliot and D. H. Hickam
Division of General Medicine, Oregon Health Sciences University, Portland.
Effective teaching of physical examination skills requires an evaluation
system that can identify trainees who need further instruction. To study
the evaluation of physical examination skills by faculty observers and
patient instructors, the reliability of their observation of medical
students performing a general physical examination was measured. Faculty
observers did not reliably evaluate 32% of examination skills. Faculty
agreement was lowest when observing components of the head, neck, and
abdominal examinations. Patient instructors, with limited faculty training,
reliably evaluated 83% of those skills that were reliably assessed by the
faculty. These findings demonstrate limitations in the current methods of
evaluating performance and point out the need to examine systems of trainee
assessment.
